Circumcision - series

Normal anatomy

The foreskin is a sleeve of tissue which covers the penis. At birth the foreskin is tightly attached. By mid-childhood it can be pulled over the penis when the penis is flaccid, or retracted back over the shaft of the penis during urination or erection.

Indications

The common indication for circumcision is cultural or religious desire for circumcision. Other indications (rare):

treatment for inability to pull back the foreskin completely (phimosis)

infection of the penis (balanitis)

Procedure

Circumcision of a newborn boy is usually done before he leaves the hospital. A numbing medication (local anesthesia such as Xylocaine) is injected into the penis to reduce pain. Ring-type clamps are placed around the foreskin, tightened like a tourniquet to reduce bleeding, and the foreskin is removed below the clamp. Sometimes a plastic clamp is used (Plastibell). The Plastibell will fall off in 5 to 8 days, after the surgical site has healed.

Aftercare

For both newborns and older children, circumcision is considered a very safe procedure with complete healing expected. Healing time for newborns usually takes about 1 week. Apply petroleum jelly after diaper changes to protect the healing incision. Some initial swelling and yellow crust formation around the incision is normal. Healing time for older children and adolescents may take up to 3 weeks. In most instances, the child will be discharged from the hospital on the day of the surgery.

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